petMD Blogs

The Daily Vet is a blog featuring veterinarians from all walks of life. Every week they will tackle entertaining, interesting, and sometimes difficult topics in the world of animal medicine – all in the hopes that their unique insights and personal experiences will help you to understand your pets.

If you’re very lucky, you’ve had the pleasure of caring for a pet that has grown so very old that she had a little trouble remembering where she was at times.

She might also have had a little trouble discerning daytime hours from night, sleeping all day and then pacing around after the rest of the household had gone to bed.

Confusion, disorientation, dementia: call it what you will. But when it affects dogs, I lovingly refer to it as "dogzheimers," otherwise known [more clinically] as "canine cognitive dysfunction."

Although the disease process in dogs may be clinically different than human Alzheimer's, its effects appear quite similar to most pet owners: sleep/wake cycle disturbances, anxiety, inappropriate vocalization, repetitive behaviors (like pacing), elimination disorders (what you might call "incontinence"), and generalized disorientation.

While some very old cats experience a less pronounced version of this disorder, it is relatively common in geriatric dogs. Hearing and vision loss, also far more common in dogs than in cats, seems to accelerate the process by accentuating the disorientation these pets experience.

Most owners don’t appear alarmed at the onset of these symptoms. They seem to take it for granted that old animals will suffer the same changes so many humans undergo in later years. But if humans with dementia are any guide, dog lovers would do well to keep their ear to the ground on these symptoms and take early action upon their manifestation.

Why? Because disorientation often yields to anxiety, and ultimately to generalized deterioration of every major organ system (as well as a predisposition to a multitude of other diseases). Moreover, dogs with dementia, in spite of their physiological limitations, can live a whole lot longer than most pet owners assume. And that would be fine, but for their perpetual state of anxiety and/or discomfort.

What’s my tack on these cases? For starters, during physical exams of older pets, I ask about alertness — especially when people start talking hearing loss and vision loss. Is the dog bumping into things at night? Is he less likely to look up when you enter a room? For pets with cataracts, even at an early stage, I suggest a trip to the ophthalmologist for an evaluation and cataract surgery, if possible.

If dogs are just starting to show signs of disorientation, I try to talk people into adhering to a stricter schedule when it comes to feeding, walking, time at home, etc. Why? Because your schedule is their schedule. And a strict routine is excellent therapy for confused pets — it’s orienting.

For more severe cases, I discuss the benefits of Anipryl (selegiline), a drug that seems to reverse some of these symptoms … to a minor extent, I must admit. Anti-anxiety drugs may also be indicated for some dogs. Amazingly, some dogs with advanced dementia are quite relaxed, but most display some degree of stress — especially when lost in a corner of a room or when they find themselves alone and awake in the middle of the night.

The most comprehensive approach to canine cognitive dysfunction includes the services of a veterinary behaviorist. Some of these specialists are miracle workers when it comes to helping owners re-orient their confused geriatric pups. I’m often surprised by how just one visit can make a tremendous difference. It’s might be expensive, but it's still far cheaper than drugs or new carpeting, for example.

So many of these dogs are euthanized before their time, simply because the incontinence or vocalization became far too much for the family to handle — and because no one took the time to explain that a dog can have a comfortable, productive life even after the loss of normal brain function. Some cases are exceptional and can’t be satisfactorily helped, every situation is different, but you’ll never know until you try.

For my part, I find that I euthanize way too many old dogs whose happiest days could still be ahead of them. It’s my firm belief that if owners could be brought around to accepting that an old dog requires only as much attention and special care as a puppy, then perhaps they wouldn’t throw up their hands in disgust over a little stool on the floor. After all, we’re going to be there ourselves someday, if we're lucky.

I recently adopted a 16 year old dog with "dogzheimers." Her owner passed away and the family that took her in decided after a week that they "didn't have time for her" so they took her to the local shelter and requested she be euthanized. The medical director convinced them to surrender her instead.

Her hearing and vision are failing and she paces around my apartment constantly when she's awake. She LOVES to go for walks though and she's learning the routine of my family and other dogs pretty quickly. She snuggles and kisses us when we pick her up. She's a sweet, happy old girl and will be living out her last days in my care.

I feel sorry for the family who couldn't see what a sweet gem she is and I sincerely they take better care of their human family members in their golden years.

Given that prevention is far more appropriate than any efforts at cure, I quote the following from a comprehensive review of studies with respect to the long-term damage from castration and ovarectomies in domestic dogs:

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"Neutered male dogs and spayed female dogs are at increased risk of progressing from mild to severe geriatric cognitive impairment compared to intact male dogs. There weren’t enough intact geriatric females available for the study to determine their risk.

Geriatric cognitive impairment includes disorientation in the house or outdoors, changes in social interactions with human family members, loss of house training, and changes in the sleep-wake cycle.

The investigators state “This finding is in line with current research on the neuro-protective roles of testosterone and estrogen at the cellular level and the role of estrogen in preventing Alzheimer’s disease in human females. One would predict that estrogens would have a similar protective role in the sexually intact female dogs; unfortunately too few sexually intact female dogs were available for inclusion in the present study to test the hypothesis”

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The full study is available here:
http://www.cultureghost.org/viewtopic.php?f=14&t=1134

It's sadly ironic that veterinarians are likely a major cause of canine senior dementia - among many other serious health problems in dogs - via their obsessive focus on amputation of integral elements of the healthy canine hormonal system, via castration and "spaying." I'd love to see less effort spent on marketing new medicines for geriatric disorders, and more emphasis on NOT causing these disorders in the first place.

Veterinarians: when are you going to recognize these well-research health costs, and stop mutilating your "patients" for a few quick bucks?

As a health care administrator I smiled when I read this because I work daily with cognitively impaired humans and yes we will be there someday. A little poo or vocalization would be a welcome alternative to losing one of my beloved animals. However, I also see when anxiety and confusion can take away all quality of life. Always an individual decision when that is gone.

Our 13-1/2 year old, mixed breed dog has been pacing a lot throughout the night, and now sometimes during the day. She wants to go out and then stands and looks around like "where am I." I have attributed this to doggie alzheimhers, and I guess that is what it is. Based on the above, we have been handling her properly with extra love and attention, and response to her needsl.

We are so lucky to have our Pepper with us for 16 years and going. He may be an oldster but he is still feisty and spoiled. He does pace at night and sometimes I may lack a few hours of sleep trying to figure out what he needs but this little guy has given us some pretty darn good years and we will keep going. I agree with a lot of what Dr. Khuly has written. Thanks for this insight.

We have three Lhasa-mix boys. Bennie will be 16 in Oct. and is definitely experiencing cognitive issues. He is taking Zentonil Plus. It is for liver problems but is also suppose to help with cognitive issues. I think part of the problem with his anxiety is definitely due to the fact that he now has limited vision and hearing.

Ben definitely roams around at night, sleeps soundly during the day, gets stuck in corners, stares at walls, barks at nothing and has the occasional accident. Ben is my little "bud" and I am grateful that he still recognizes me.